Objective: This study aimed to identify the rate of discharge of hospitalized patients against medical advice (DAMA) and its risk factors, including length of stay as well as to assess patients’ outcome after signing DAMA. Methods: This retrospective study included Saudi patients aged 14 years and above who were presented to the Emergency Department (ED) at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia and left against medical advice from January 2021 to March 2022. Included patients were interviewed via phone calls to investigate the reasons of DAMA. Results: The study included 186 DAMA patients with 52.7% females and majority (21%) falling in the 30-39 years category. The most common complaint was shortness of breath (13.4%). The prevalence of DAMA was 0.89%. The length of stay in the ED was the common reason for DAMA (60.7%). The length of stay varied, and the highest percentage of patients (31.2%) stayed in the ED for 2-3 hours. Outpatient treatment was the most common outcome after DAMA (41.4%). There was a significant association between insurance type, the reason for leaving the hospital, and the length of stay in the ED (p=0.001 and p<0.001, respectively). There was a significant association between the mode of presentation and outcome (p=0.002). Conclusion: The findings suggested that strategies aimed at reducing the length of stay in the ED and improving the continuity of care might help to minimize the incidence of DAMA and its adverse health outcomes.

Keywords: Discharge against medical advice, Emergency department, Patient, Hospital, Saudi Arabia.